Monday , January 17 2022

[건강칼럼] Uveitis that causes vision loss and blindness



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Most eye diseases that cause blindness are usually associated with aging, but there are diseases that can result in blindness even in young and healthy patients. What is uveitis that can cause sudden onset and cause serious symptoms?

What is uveitis?

Lee, who has been in normal health without any special medical problems and has never been to visit a hospital, has been suffering from decreased visual acuity after the onset of redness and pain in his right eye. I felt tired at first, but the symptoms became very severe. At the time of admission, my vision reached safety level (I could not see the vision plate and could count the number of fingers before 30cm). Through ophthalmology and blood tests, The cause of uveitis is related to ankylosing spondylitis.

Uveitis is an inflammation that literally occurs in the uvea. The uvea is an iris that forms the middle layer of the eyeball (brown tissue in the front part of the eye), a ciliary body, and a choroid. It is rich in blood vessels and prone to inflammation, and the inflammation that occurs here is called uveitis. Uveitis is divided into anterior uveitis, middle uveitis and uveitis depending on its location, and all forms of uveitis are referred to as total uveitis. Several causes such as germs, viruses, parasites, trauma, and inflammatory systemic diseases are known, but idiopathic uveitis may occur without any specific cause.

Symptoms and Diagnosis of Uveitis

Uveitis can have a variety of symptoms depending on its location and degree of inflammation. Anterior uveitis is usually acute. Congestion, pain, and bright light can cause symptoms such as tearing of the eyes, and eye inflammation may be caused by severe inflammation. In middle uveitis and uveitis, the main symptoms are decreased vision and insomnia. In cases of uveitis, glare and varicose may appear.

Symptoms caused by uveitis may also occur in other inflammatory diseases such as conjunctivitis, keratitis, or scleritis, so you should visit your ophthalmologist to make an accurate diagnosis. For diagnosis, it is necessary to confirm the inflammation in the anterior part of the anterior eye through slit-lamp microscopy, and intraocular pressure test is necessary because it can be accompanied by hypotony or ocular hypertension. In some cases, fundus examination is performed to confirm inflammation in the back of the eye, and fluorescein angiography or optical coherence tomography is performed in order to more accurately discriminate between other ocular diseases and retinal complications.

In addition to ophthalmologic examinations for diagnosis, it is necessary to identify systemic diseases accompanied by uveitis. Blood tests including genetic tests and radiological examinations are necessary for this. If the patient has inflammatory systemic disease or autoimmune disease, treatment should be done only if the internal medicine is cooperated and managed. Therefore, it is important to examine this systemic disease. Despite a variety of tests, there are cases where no apparent cause can be found.

Complications due to uveitis

Chronic recurrent uveitis itself can also reduce visual acuity. Secondary visual loss can also occur if the optic nerve is involved or the macular papules develop. Other complications of uveitis include iris adhesion, iris atrophy, cataract, glaucoma, retinal detachment, retinal detachment, retinal atrophy, uveitic atrophy, optic atrophy, guide angiogenesis, vitreous hemorrhage, Loss and eyeball conditions may occur. The eyeball is a condition in which the overall function of the eye is so bad that it causes black opacity, decreased intraocular pressure, decreased eye size, and loss of vision.

In the treatment of uveitis, various drugs such as steroids are used. In the case of drug treatment for a long time, various problems such as cataract, glaucoma, ptosis, gastric ulcer, diabetes and hypertension may occur due to the drug, need.

Treatment of uveitis

If a cause is found, treatment appropriate to the cause of the disease is performed. In case of infectious causes, antibiotics and antivirals suitable for causative bacteria or viruses that cause infections will be used. If not infectious, topical medicines for controlling inflammation, such as eye drops or oral medicines (steroids), are necessary. Pain relief and eye irritation (a paralytic agent) that shakes the pupil for the purpose of preventing posterior iris adhesion to the surrounding tissue is treated with eye drops. If necessary, eye or intraocular steroid injections may be performed in addition to eye / oral steroids. Inflammation does not diminish or recur, and in the case of this recurrent, chronic inflammation, immunosuppressants are sometimes needed, and in this case it is necessary to periodically perform a blood test for possible adverse drug reactions. It is associated with inflammation and may cause various intraocular complications such as macular edema, exudative retinal detachment, and glaucoma. In addition, these complications can leave aftereffects even if the inflammation subsides, and the visual disturbances caused by these complications can be left behind, so continuous observation and appropriate treatment are important. Therefore, it is recommended to visit the ophthalmologic clinic without any delay if the same symptoms recur after the treatment, to minimize the damage of the eye by diagnosis and treatment, and to receive regular ophthalmologic examination without recurrence.

Although uveitis is a serious ophthalmologic disease that can cause blindness and blindness, it is still a popular public awareness of the disease. I think it is usually 'tired' and 'temporarily' Experience. It is important to keep an eye on health care to avoid the unfortunate situation when you miss the appropriate treatment period and after the illness has progressed considerably.

Q & A about uveitis

Q. How are uveitis symptoms different from conjunctivitis?

A. Uveitis is often confused with conjunctivitis, and common pneumococcal conjunctivitis usually causes eye rash, itching, glare, pain, and redness. Uveitis may also cause pain, redness, and glare, but there is little sense of foreign body and itching. Symptoms of congestion also occur in the pre-whites of conjunctivitis, but in uveitis it occurs more often in the vicinity of blackheads (corneas).

Q. Should uveitis be treated quickly?

A. Depending on the severity of the disease, if the inflammation is very severe, if you do not receive proper treatment within a few days, you may end up with structural damage to the eye and not recover. Therefore, it is good to receive eye care as soon as possible.

Q. How should I administer steroid eye drops?

A. Steroid eye drops are not transparent. It is necessary to shake the eyewash bottle thoroughly before mixing the eye drops, mix the drugs evenly, and then stop. Also, after the inflammation has been controlled, it should be gradually cut off. If you do not take steroid eye drops for a long time indefinitely, complications such as cataracts, glaucoma, and keratitis may occur.

Q. My body is swollen after eating steroid medication, is it okay?

A. When taking steroid pills, swelling changes can occur gradually. In short-term use, the drug can be recovered after the drug is discontinued, but it should be used after consultation with the doctor.

Q. I did not receive treatment on the promised date of steroid eye drops treatment. Can I continue to use eyedrops and get medical care in a month?

A. Steroid eye drops should be examined by an eye doctor and adjusted for use and timing. If you use it for a long time, you may get cataracts, glaucoma, keratitis and so on.

[검진문의]

Gyeongbuk Branch (Northern Daegu Medical Center) 053-350-9000, http://www.kahpgb.co.kr

Daegu Branch (Daegu East Checkup Center) 053-757-0500, http://daegu.kahp.or.kr

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